Jenna Elizabeth Ishmael, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Havana, IL
NPI 1942928866 · NPPES record last updated Feb 27, 2023
Key facts
- NPI
- 1942928866
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209025689 (IL)
- Practice address
- 615 N Promenade St
Havana, IL 62644-1243 - Phone
- (309) 543-6600
- NPI assigned
- Aug 16, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mason Hospital District
Practice addresses (Care Compare)
615 N Promenade St
Havana, IL 62644-1243
Phone (309) 543-8510
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220923002975 | IL | Practitioner - Nurse Practitioner | 2466837638 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mason Hospital District | Current | Accepting new patients | |
| Mason Hospital District | Current |
Accepting new patients | |
| Mason Hospital District | Current |
Accepting new patients | |
| Mason Hospital District | Past | Accepting new patients |
Locations
615 N Promenade St
Havana, IL 62644
Phone (309) 543-8510
122 E Elm St
Mason City, IL 62664
Phone (217) 482-3400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209025689 | IL | Yes |
Addresses
Primary practice location
615 N Promenade St
Havana, IL 62644-1243
Mailing address
615 N Promenade St
Havana, IL 62644-1243
Phone (309) 543-6600
Other practice location 1
122 E Elm St
Mason City, IL 62664-1410
Phone (217) 482-3400
Other providers in Havana, IL
- Stuart Hickerson
- Highland Park CVS LLC
- Chase Holtman
- HSHS Medical Group Inc
- Justin Huggins
- Marsha R Kirchner
- Kelsey Elizabeth Knake
- Sarah Knake
- Kelley D Lawless
- Liberty Dental, Inc
All providers in Havana, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.